Quantitative left ventricular angiocardiographic findings in mitral stenosis: Detailed analysis of the anterolateral wall of the left ventricle

Abstract

The observation of diminished motion of the anterolateral wall of the left ventricle in patients with mitral stenosis initiated this study. Twelve patients with mitral stenosis, 4 with right ventricular enlargement of other origin, and 8 normal subjects formed the basis for a quantitative analysis of the left ventricle by left cineventriculography. Our study indicated a markedly impaired contractility of the anterolateral wall of the left ventricle and posterobasal area in our patients with mitral stenosis. The 4 patients with right ventricular enlargement showed the same phenomenon of the anterolateral wall, but an abnormality of the posterobasal area was not evident. A reduced ejection was found in both groups. Our study further implicates a myocardial factor as a cause of reduced cardiac output in mitral stenosis. Lastly, as a potential explanation, we postulate that right ventricular enlargement, in some patients, may produce secondary abnormalities of left ventricular contractility.